Researchers Explore Adolescent Blood Pressure Trends

Shakia T. Hardy, PhD

A better understanding on blood pressure trends for children could allow researchers to develop better intervention plans to lower blood pressure before adulthood.

A team, led by Shakia T. Hardy, PhD, Department of Epidemiology, University of Alabama at Birmingham, determined whether systolic blood pressure and diastolic blood pressure levels among US pediatric patients has changed during the last 20 years.

Higher blood pressure in pediatric patients is linked to an increased risk for various cardiovascular diseases, including hypertension and subclinical cardiovascular disease in adulthood.

The Patients

In the serial cross-sectional analysis, the researchers used the data of 9117 children between 8-12 years old and 10,156 adolescents between 13-17 years old weighted to the US population from 1999-2002 to 2015-2018 from the National Health and Nutrition Examination Survey.

For the children between 8-12 years old in 2015-2018, the mean age was 10.5 years old. For the patients between 13-17 years old in 2015-2018 the mean age was 15.5 years old

The researchers sought primary outcomes of the mean systolic blood pressure and mean diastolic blood pressure.

Age-Adjusted Results

The age-adjusted mean systolic blood pressure decreased from 102.4 (95% CI, 101.7-103.1) mm Hg in 1999-2002 to 101.5 (95% CI, 100.8-102.2) mm Hg in 2011-2014 among the participants between 8-12 years old. The systolic blood pressure then increased to 102.5 95% CI, 101.9-103.2) mm Hg in 2015-2018.

On the other hand, the age-adjusted mean diastolic blood pressure decreased from 57.2 (95% CI, 56.5-58.0) mm Hg in 1999-2002 to 51.9 (95% CI, 50.1-53.7) mm Hg in 2011-2014 and increased to 53.2 (95% CI, 52.2-54.1) mm Hg in 2015-2018.

In the adolescent arm of the study, the researchers found individuals aged 13-17 years, age-adjusted mean SBP decreased from 109.2 (95% CI, 108.7-109.7) mm Hg in 1999-2002 to 108.4 (95% CI, 107.8-109.1) mm Hg in 2011-2014. This remained unchanged in 2015-2018 (108.4 [95% CI, 107.8-109.1] mm Hg).

The mean diastolic blood pressure decreased from 62.6 (95% CI, 61.7-63.5) mm Hg in 1999-2002 to 59.6 (95% CI, 58.2-60.9) mm Hg in 2011-2014 and then increased to 60.8 (95% CI, 59.8-61.7) mm Hg in 2015-2018.

Impact of Weight

There was also trendlines found based on the circumstances of the individual child.

“Among children aged 8 to 12 years, mean SBP was 3.2 (95% CI, 1.7-4.6) mm Hg higher among those with overweight and 6.8 (95% CI, 5.6-8.1) mm Hg higher among those with obesity compared with normal weight; mean DBP was 3.2 (95% CI, 0.7-5.6) mm Hg higher among those with overweight and 3.5 (95% CI, 1.9- 5.1) mm Hg higher among those with obesity compared with normal weight,” the authors wrote.

For the patients between 13-17 years old, the mean systolic blood pressure was 3.5 (95% CI 1.9-5.1) mm Hg higher among those with overweight, and 6.6 (95% CI, 5.2-8.0) mm Hg higher among those with obesity compared with normal weight, 4.8 (95% CI, 3.8-5.8) mm Hg higher among boys compared with girls, and 3.0 (95% CI, 1.7-4.3) mm Hg higher among non-Hispanic Black compared with non-Hispanic White participants.

“Despite an overall decline in mean SBP and DBP from 1999-2002 to 2015-2018, BP levels among children and adolescents may have increased from 2011-2014 to 2015-2018,” the authors wrote.

The study, “Trends in Blood Pressure and Hypertension Among US Children and Adolescents, 1999-2018,” was published online in JAMA Network Open.